Update on bacterial detection methods in chronic rhinosinusitis: implications for clinicians and research scientists

Background: The exact etiologic role of microbes in chronic rhinosinusitis (CRS) remains unclear, due in part to inconsistencies and difficulties of microbiological detection. However, methodological advances now permit comprehensive analysis of microbial communities of the sinonasal region. This review summarizes recent developments in microbial detection technologies as exemplified by their application in the study of CRS. Recent Findings: A variety of novel methods for specimen collection, microbial culture, cultivar identification, and microscopic analysis of CRS specimens have been used in recent studies. Moreover, the advent of culture-independent methodologies based on the detection of microbial nucleic acids has greatly expanded the range of microorganisms, including fastidious species, that can be assayed. Many techniques use biochemical interactions to identify nucleic acids as markers for specific species. Summary: Technological innovations in microbiology have radically improved the sensitivity and accuracy of microbial detection and identification in CRS specimens. Further application of these microbiological tools to CRS research should provide greater insight into the roles of microbial pathogens and commensals in sinus health and disease. Ultimately, translation of research results into clinical diagnostic technology will improve patient outcomes in this chronic disease. (C) 2011 ARS-AAOA, LLC.